Donation Application - Individual/Family

Please complete the following information for the family/individual in need of financial assistance.

Full Name: *

Other Members of Household: (Last Name, First Name, Relationship)

Address: *

Phone Number: *

Employer:

Reason for donation request and specific use of funds: *

$ Amount Requested:

Is the individual/family receiving any other form of financial assistance?

Yes

No

If yes, please list.

Applicant Agreement *

Yes, I am in agreement with the statement below.

The information contained in this statement this statement is for the purpose of obtaining funding from the Oakdale Electric Trust on behalf of the undersigned. Each undersigned understands that the information
provided herein is used in deciding to grant fundin
g, and each undersigned represents and warrants tha
t
the information provided is true and complete and that the Oakdale Electric Trust may consider this statement as continuing to be true and correct until a written notice of a change is provided. The
Oakdale Electric Trust is authorized to make all in
quiries they deem necessary to verify the accuracy
of
the statements made herein

Date of Application:

Month

Day

Year

Leave this field blank

CAPTCHA

This question is for testing whether you are a human visitor and to prevent automated spam submissions.

Drag or click the correct shape to the grey "drop area".

Quick Links:

Touchstone Energy® Cooperatives is a national network of electric cooperatives across 46 states that provides resources and leverages partnerships to help member cooperatives and their employees better engage and serve their members. By working together, Touchstone Energy cooperatives stand as a source of power and information to their 32 million member-owners every day.